Ukushaywa unhlangothi emakati

Izinto ezibangela unhlangothi emakati

Okokuqala, unhlangothi emakatini kungenzeka ngenxa yesisindo somzimba eseqile. Ukukhuluphala ngokuvamile kuhambisana nezifo ezihambisanayo zesimiso sokujikeleza kwegazi, inhliziyo. Kanye nokungasebenzi komzimba okwanele kwesilwane, lokhu kuholela ekuminyeneni kwegazi, ukwakheka kwamahlule egazi, ukuthuthukiswa kwe-atherosclerosis, ukungasebenzi kahle kwezindonga zemithambo yegazi, nokuntuleka kwezakhi kanye nomoya-mpilo. Iqembu lezingozi lakhiwe amakati ngemva kokuthenwa (ukuvalwa inzalo) kanye nokuguga.

Ngaphezu kwalokho, izici ezilandelayo zingavusa i-pathology:

• ukucindezeleka;
• kwehla umfutho wegazi;
• umfutho wegazi ophakeme;
• anomalies yesistimu yenhliziyo;
• i-helminthiases;
• ukudakwa isikhathi eside;
• ukwehluleka kwezinso;
• ukulimala (ikhanda, umgogodla);
• isifo sikashukela;
• izimila ezimbi;
• I-Cushing’s syndrome (ukukhiqizwa ngokweqile kwe-cortisol).

Nakuba kunezici eziningi, futhi zonke zihlukile ngokwezimpawu, ukubaluleka kanye nomthelela ku-CVS, izimpawu ze-stroke esimweni ngasinye zizofana.

Izinhlobo ze-stroke emakati nezimbangela zazo

Kunezinhlobo ezintathu zokushaywa unhlangothi emakati.

ischemic

Umkhumbi wegazi uvalwe nge-thrombus (i-atherosclerotic plaque), i-ischemia iqala (ukugeleza kwegazi okwanele kumaseli). Ngenxa yalokho, izicubu zezinzwa aziwutholi umoya-mpilo futhi ziyafa. Nge-ischemic stroke, ukufa okukhulu kwama-neurons noma ukufa kwawo okuyingxenye kungabonwa. Ukuvuvukala kuvela ebuchosheni, ukunikezwa kwegazi kuphazamiseka, futhi kwenzeka i-edema.

Ukushaywa kwe-Ischemic emakati, kaningi, kwenzeka ngokumelene nesizinda salokhu:

• isifo sezinso;
• isifo sikashukela;
• i-cholesterol ephezulu;
• izifo zesistimu yenhliziyo;
• izifo ze-parasite yegazi;
• I-Cushing's syndrome.

Ukopha

Umkhumbi wegazi wobuchopho uyaqhuma, ukopha kwenzeka ebuchosheni. I-hematoma icindezela izicubu ezizungezile, ivimbela ukusebenza kwazo okuvamile.

Izici eziholela ekushayweni ukopha kwamakati:

• ukulimala kwekhanda;
• phlebitis (ukuvuvukala emithanjeni);
• ama-neoplasms ebuchosheni;
• izifo ezenzeka ngomkhuhlane;
• umfutho wegazi ophakeme;
• ubuthi;
• ukukhuluphala ngokweqile.

I-Microstroke

Njengokushaywa kwe-ischemic, kulokhu, i-pathology iqala ngenxa yokuvinjelwa komkhumbi wegazi nge-thrombus. Kodwa-ke, ukwephulwa kokugeleza kwegazi akubanzi kakhulu, futhi ihlule lingancibilika lodwa emini ngaphandle kwemiphumela eshiwo. Ngesikhathi esifanayo, kuyingozi ukubukela phansi i-microstroke. Ukwenzeka kwayo (ngokuvamile izikhathi ezingaphezu kwesisodwa) kubonisa ukuba khona kwezinkinga ezinkulu ngokujikeleza kwegazi, kuyisandulela sokushaywa okunamandla, futhi kungaholela ekukhubazekeni kwesilwane esifuywayo.

Izinto ezibangela i-microstroke emakati:

• ukucindezeleka;
• umfutho wegazi ophakeme;
• ukukhuluphala;
• i-pathology yodonga lwe-vascular.

Izimpawu ze-pathology

Uma ukushaya kwenzeka ngokuzumayo, futhi isilwane siseduze nomnikazi, khona-ke ngeke kwenzeke ukungaboni izimpawu. Kodwa ngezinye izikhathi isithombe somtholampilo sikhula kancane kancane, ngisho nangezinsuku ezimbalwa, sibonise ukuphambuka okucashile.

I-stroke ibonakala kanjani emakatini? Isibonakaliso esiyinhloko se-stroke ekati izinguquko emehlweni: abafundi bangaba ubukhulu obuhlukene, futhi bashintshe njalo futhi kungakhathaliseki ukuthi yimaphi amathonya angaphandle.

Ezinye izimpawu zifaka:

• ukunensa okungazelelwe, ukukhathala, ukungabi nandaba nemidlalo, ukudla, umnikazi;
• "iqhwa" endaweni (uma i-stroke iqala ngesivinini sombani) nokulahlekelwa ukwazi;
• isikhundla esingeyona eyemvelo yekhanda (ehlangothini lwayo noma ukunyakazisa);
• ukuxhwala okungazelelwe, ukuhudula izitho zomzimba; njengomthetho, ukulahlekelwa ukuhamba kuthinta i-paws eyodwa yekati;
• umlomo ovulekile, ulimi oluphumayo;
• ukuvuza kwamathe ngokuzenzakalelayo;
• ukulahlekelwa kokuma emkhathini, isifiso sokucasha endaweni ecashile;
• ukuphuma komchamo noma indle ngokuzenzakalelayo;
• ukulahlekelwa ukuzwa; ikati aliphenduli kubizo lomnikazi;
• ukopha emehlweni, ukuphazamiseka kokubona, inyama ibe yimpumputhe; isilwane singakhubeka ezintweni, sikhubeke, siwe;
• ukuncibilika kwemisipha okudlikizekayo kokuqina okuhlukahlukene kanye nemvamisa;
• ubunzima bokuhlafuna nokugwinya ukudla namanzi; ngenxa yalokho, isilwane singase senqabe ukudla;
• ukuphazamiseka kwe-gait - ngesikhathi sokunyakaza, ikati linganyakaza, lidideke, lingaqiniseki, liwele ngezidladla zalo (paw);
• ukuphefumula njalo
• isithuthwane.

Izimpawu ze-microstroke yilezi:

• ukuhlanza;
• ukuntula ukudla;
• ukukhathala, ukozela;
• ukwesaba ukukhanya;
• umfutho wehla, ovezwa ngokufiphala kwesilwane esifuywayo.

Izimpawu ze-stroke, ikakhulukazi uma zimbalwa, zifana nezimpawu zezinye izifo, ngakho-ke kungcono ukuyisa ikati kudokotela wezilwane ngaphandle kokulinda izinkinga. Mhlawumbe inkinga isesimweni esithathelwanayo, i-oncology, ukuphazamiseka ohlelweni lwezinzwa oluphakathi.

Usizo lokuqala lwekati elinesifo sohlangothi

Uma ubona noma yiziphi izimpawu ze-stroke ekatini lakho, shayela udokotela wakho wezilwane. Tshela udokotela ngokuningiliziwe ngalokho okwenzekile, buza ukuthi yiziphi izinyathelo ezingenziwa, noma ngabe ukuthutha kuzobe kuphephile okwamanje. Mhlawumbe uchwepheshe uzofika endlini.

Ngokuvamile, usizo lokuqala lwekati elinesifo sohlangothi lumi kanje:

• isilwane esifuywayo sibekwe endaweni evundlile, ohlangothini lwaso;
• uma ukuhlanza sekwenzekile noma kuphuma amathe, susa izinsalela zokuhlanza noketshezi oluningi nge-napkin;
• dala umoya okhululekile, nciphisa ukukhanya, ususe imisindo engadingekile;
• uma ikati ligqoke ikhola, liyasuswa;
• vula iwindi ukuze kungene umoya.

Ngaphambi kokuba udokotela afike, isilwane esifuywayo siyashaywa futhi kukhulunywe naso.

Uma udokotela engenakuthintwa, ikati kufanele liyiswe emtholampilo ngokushesha ngangokunokwenzeka. Kuyoba kuhle uma kukhona omunye umuntu eduze ozoqinisekisa ukuthi isilwane sisesimweni esifanele. Uma kungenjalo, ungafaka isilwane ebhokisini noma kubhasikidi bese usibeka esihlalweni esilandelayo.

Ukuxilongwa Kwe-Stroke Emakati

Ngokuvamile, ukuxilongwa akunzima, futhi kwanele ukuba uchwepheshe ahlole ikati ukuze anqume isifo sohlangothi. Kodwa kusafanele udlule ekuhlolweni kwaselabhorethri kanye ne-hardware ukuze uthole imbangela eqondile, uhlobo lwe-pathology, izinga lokulimala kwezicubu. Lokhu kuzokwenza kube nokwenzeka ukukhipha ezinye izifo, ukwenza i-prognosis, ukunikeza ukwelashwa okwanele. Ukuze wenze lokhu, ikati lingase libekwe ukuhlolwa kwegazi nomchamo, i-MRI noma i-CT scan yobuchopho.

Ukwelashwa emtholampilo wezilwane

Ngokuya ngesimo sesilwane, okokuqala, izenzo zikadokotela zihloselwe ukuzinza. Kubalulekile ukuvimbela ukulahlekelwa amandla nokubuyisela amanzi kanye nebhalansi ye-electrolyte. Esikhathini esizayo, ukwelashwa kuzobe kuhloswe ukuqeda izimpawu, ukuvimbela ukuthuthukiswa kwezinkinga. Kulokhu, amaqembu alandelayo ezidakamizwa asetshenziswa:

• glucocorticosteroids (ukunciphisa ukuvuvukala, ukususa ukuvuvukala);
• ama-analgesics (ukunciphisa ubuhlungu);
• ama-immunomodulators (ukuvuselela ukuzivikela komzimba);
• ama-antispasmodics (ukunciphisa izicubu zemisipha, ukuvimbela ama-cramps);
• ama-neuroprotectors (vikela amangqamuzana ezinzwa ekulimaleni okuqhubekayo, buyisela ukuxhumana phakathi kwama-neurons ngangokunokwenzeka).

Ngaphezu kwalokho, ama-diuretics, izidakamizwa ezilwa namagciwane, ama-sedative, antiemetics nezinye izidakamizwa zingase zibekwe ngaphezu kwalokho, njengoba kudingekile kulokhu noma kuleso simo. Uma kwenzeka i-hypoxia ecacile, isilwane sizonikezwa ukwelashwa kwe-oksijeni, futhi uma kwenzeka ukuxubana okukhulu, kungenzeka ukubeka ikati ebuthongweni bokwenziwa ngokunikeza i-anesthesia.

Ukwelashwa kwezilwane ezifuywayo ekhaya

Ezinsukwini zokuqala ngemva kokushaywa unhlangothi, ikati libuthakathaka kakhulu futhi lidinga ukugadwa njalo. Ngaphezu kwalokho, izinkinga zingase zingabonakali ngokushesha, ngakho-ke kungcono ukushiya isilwane esibhedlela okwesikhashana. Ochwepheshe ngeke nje baqaphe umphumela wezidakamizwa, kodwa futhi baphendule ngesikhathi ngokuthuthukiswa kokubuyela emuva.

Uma isimo sesilwane sivuma noma kungenakwenzeka ukusishiya emtholampilo, kuzodingeka uzelaphe ngokwakho. Ukunakekelwa okuningi kwasekhaya kuqukethe imijovo (e-intramuscular and/noma intravenous), ukudla, nokuphumula.

Udokotela wakho angase akunikeze izinketho ezihlukene zokujova. I-subcutaneous iyona elula kakhulu ukuyenza, noma ngubani angakwazi kahle leli khono. Imijovo ngaphansi kwesikhumba ifakwa ikakhulukazi lapho kubuna. Imijovo emsipha inzima kakhulu, kodwa futhi ayivezi noma yibuphi ubunzima obuthile. Kwanele ukubuza udokotela wezilwane ngokuningiliziwe noma ukufunda ngezici zesilungiselelo, ukubona ukuthi umjovo we-intramuscular wenziwa kanjani emtholampilo.

Isimo sibucayi kakhulu ngemijovo efakwa emthanjeni. Uma ungenalo leli khono, zilungiselele ukuvakashelwa njalo emtholampilo ukuze uthole izinqubo. Enye inketho ukubiza uchwepheshe ekhaya.

Endlini yesilwane, udinga ukudala izimo ezithile. Isibonelo, ukuze isilwane singacindezeli, kufanele uhambise indawo yokulala phansi (susa obhasikidi, izindlu, njalonjalo), qinisekisa ukuthi ukudla namanzi kutholakala eduze komunye nomunye.

Uma ikati lihamba kancane noma lingenakunyakaziswa ngokuphelele, uzodinga ukubhucungwa kwamalungu nsuku zonke kanye noshintsho esimweni. Lokhu kuzokwenza kube nokwenzeka ukuvimbela ukuqina kwe-lymph negazi, ukuvimbela ukwakheka kwama-bedsores.

Ukukhanya kwelanga akufanele kwehlele esilwaneni. Kuyinto efiselekayo ukuthi ikati lingaphinde liphazanyiswe ngamalungu omndeni (ikakhulukazi izingane) nezinye izilwane ezifuywayo.

Uma ikati ligcine umsebenzi wokuhlafuna ngemva kokushaywa unhlangothi, lingagwinya ukudla, khona-ke akukho zinguquko ezenziwa ekudleni. Ukuvimbela ukuthuthukiswa kwe-atherosclerosis nokukhuluphala, kunconywa ukunciphisa okuqukethwe kwamafutha ezilwane ekudleni. Uma kungenjalo, ukondla kwenziwa ngokudla okuwuketshezi ngesirinji, ibhodlela lomntwana, futhi ngezinye izikhathi ukusetshenziswa kwe-dropper kuyadingeka.

Ukwengeza, udokotela angase anikeze i-physiotherapy: i-electrophoresis, i-magnetotherapy. Lokhu kuzodinga nokuvakashelwa emtholampilo wezilwane.

Imiphumela kanye nezinkinga ezingenzeka

Udinga ukulungiselela iqiniso lokuthi isikhathi sokuvuselela ngemva kokushaywa yi-stroke ekati sizohlala isikhathi eside, kuze kube yiminyaka eminingana, kuye ngokuthi izinga lokulimala kwengqondo. Ngaphezu kwalokho, ezimweni eziningi, akunakwenzeka ukugwema noma yiziphi izinkinga nemiphumela. Amathuba nokuqina kwabo kuncike ekufikeni kwesikhathi kokuxhumana nodokotela wezilwane, ukufaneleka kokwelashwa, izici zenkathi yokuvuselela, umzimba wekati, nezinye izici eziningi.

Imiphumela evamile yokushaywa unhlangothi ekatini:

• ukuxhwala, ukukhubazeka ingxenye noma okuphelele kwezinye izitho;
• ukulahlekelwa ukuzwa okuyingxenye noma okuphelele;
• ukungaboni kahle, ubumpumputhe;
• ukukhubazeka kwenkumbulo (ikati lingase lingaboni umnikazi, libaleke kuye, lilahlekele endaweni evamile).

Amakati alele embhedeni asongelwa i-aspiration pneumonia, isifo samaphaphu esivuvukalayo esikhula ngenxa yokuminyana ngenxa yokuntuleka kokusebenza kwezimoto.

isibikezelo

I-prognosis iyathandeka uma ikati lisizwa ngesikhathi esifanele - kungakapheli ihora ngemva kokushaywa unhlangothi. Ukulimala kobuchopho endaweni nakho kubhekwa njengokufanelekile, ngokuphambene nomonakalo omkhulu.

Uma i-stroke ekati ihambisana nokuphuma kwegazi okukhulu, i-sepsis, akufanele uthembele ekuthuthukisweni kwesimo nokululama. Okufanayo kusebenza ku-stroke ye-hemorrhagic uma kuqhathaniswa ne-ischemic.

Ukungahambisani nezincomo kanye nemiyalelo kadokotela, ukwelashwa okungaphelele kungaholela ekubuyiseleni ngisho noma kwenzeka ukuthuthukiswa okubonakalayo empilweni yesilwane. Lokhu kuyiqiniso ikakhulukazi kuma-microstrokes - isilwane silungiswa (noma nje sizizwa kahle ngemva kwesiqephu esifushane sokugula), umnikazi uyayeka ukumyisa ku-physiotherapy, massage, imijovo, njalonjalo. Umphumela uba ukuwohloka okungazelelwe, ukubuyela emuva ngamandla amakhulu omthelela, umphumela obulalayo ungenzeka.

Indlela yokuvimbela unhlangothi emakati

Azikho izinyathelo ezikhethekile ezingavimbela ukuthuthukiswa kwe-stroke ekati. Unganciphisa ingozi yokuvela kwayo ngokunakekela ikati futhi unikeze izimo ezinhle kuye.

Uhlu lwezinyathelo zokuvimbela:

• gcina isisindo sesilwane esifuywayo ngaphakathi kwebanga elijwayelekile, uma kunesidingo sokukhuluphala, qapha okuqukethwe kwekhalori kanye nevolumu yokudla, ibhalansi yezakhi (amaprotheni kufanele okungenani abe ngu-50%);
• ukugoma okufika ngesikhathi futhi wenze i-antiparasitic prophylaxis;
• ngokushesha nje lapho kuvela izimpawu zokuqala zesifo, thwala isilwane emtholampilo ngaphandle kokulinda isithombe esigcwele somtholampilo;
• lawula umfutho wegazi emakatini asengozini (okukhuluphele, okucatshangelwe ukushaywa unhlangothi, asebekhulile);
• ungavumeli isilwane ukuthi sihlangane nezinto ezinobuthi nezinobuthi;
• vimbela ukuwa, ukulimala;
• gwema ukudala izimo ezicindezelayo zekati, sebenzisa ngenkuthalo ama-sedatives (ngemuva kokubonisana nodokotela wezilwane), isibonelo, lapho uhamba;
• hlinzeka nge-oxygen eyanele ekamelweni.

Ngaphezu kwalokho, kubalulekile ukuvakashela udokotela wezilwane njalo. Ukunikezwa kwegazi okuyisisekelo, ukuhlolwa kwezokwelapha ngonyaka kuzosiza ukuvimbela isifo sohlangothi kuphela, kodwa futhi nezinye izifo eziningi.